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Canada’s Opioid Crisis: Delivering Robust Evidence to Guide Our Response

Published on: May 29, 2017
Result type: Report

CADTH is deeply concerned about the opioid crisis that is devastating communities, families, and individuals across Canada.

In November 2016 we joined federal and jurisdictional ministries of health, pan-Canadian organizations, and other key groups at the National Opioid Summit, and shortly after we announced our commitment to the Joint Statement of Action to Address the Opioid Crisis.

By November 2017: Analyzing the international literature to identify best practices and provide evidence-based recommendations, advice, and decision support tools that will inform and guide patients, clinicians and policy-makers regarding pain management interventions (drug and non-drug), and the treatment of opioid addiction.

The opioid crisis demands that we take decisive action and that policy and practice decisions be informed by credible evidence. CADTH is moving quickly to make sure the best available evidence on both drug and non-drug treatment options is readily and widely available to governments, health care providers, and patients across Canada.

What are we working on?

Some of our recent actions include:

  1. Addressing specific questions quickly. Through our Rapid Response program we’re scoping a wide variety of research questions and delivering the evidence in a range of formats, from a list of relevant scientific articles to more extensive reports that include evidence appraisal and peer-review. New reports are added to our website often.
  2. Centralizing the evidence online. We launched two evidence bundles — cadth.ca/opioids and cadth.ca/pain — to pull together all our related work and allow for quick browsing by category. Links to these sites were recently included as practical resources in the new Canadian Guideline for Opioids for Chronic Non-Cancer Pain.
  3. Identifying and appraising the evidence around emerging treatment options. We’re scanning the horizon and assessing new evidence, allowing decision-makers to stay informed and plan ahead. Our latest is a report on the Probuphine implant, and we’re working on an assessment of Vivitrol, an injectable form of naltrexone.
  4. Producing environmental scans on policy and practice issues. We’re gathering information, from across Canada and beyond, on opioid-related policies and practices. Our latest is a look at the North American landscape of opioids with tamper-resistance or abuse-deterrent features.
  5. Partnering with organizations to help move evidence and knowledge into action. We’re collaborating with a wide variety of clinical associations and other pan-Canadian groups to develop tools that will help support informed policy and practice decisions.

Hot topics — Our Latest Reports

REPORT WHAT YOU’LL FIND

Sustained Release Oral Morphine, Injectable Hydromorphone, and Prescription Diacetylmorphine for Opioid Use Disorder: Clinical and Cost-Effectiveness, and Guidelines
(Summary of Abstracts, April 2017)

This report provides a high-level summary of:

  • Four systematic reviews
  • Seven randomized controlled trials
  • Two non-randomized studies
  • One economic evaluation
  • One evidence-based guideline

Strategies for the Reduction or Discontinuation of Opioids: Guidelines
(Summary of Abstracts, April 2017)

This report provides a high-level summary of six evidence-based guidelines regarding:

  • Tapering
  • Rotating
  • Switching, or
  • Crossover strategies

Physical Therapy Treatments for Chronic Non-Cancer Pain: A Review of Guidelines
(Summary with Critical Appraisal, November 2016)

This report summarizes and critically appraises key recommendations about the use of physical therapy interventions for chronic, non-cancer pain from 11 evidence-based guidelines.

It also includes implications for decision or policy-making.

Opioid Formulations with Tamper-Resistance or Abuse-Deterrent Features — Products and Policies
(Environmental Scan, March 2017)

This report addresses some of these key questions:

  • What opioids are available in Canada with tamper-resistance or abuse-deterrent features?
  • What products received labelling for these features by the US FDA?
  • What is in the North American pipeline?
  • What are current and emerging North American regulatory frameworks and reimbursement practices for these products?
  • What are potential implementation issues?

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